Tuesday, December 23, 2008

Abortion deaths in 1920-1921

We need some perspective first. All surgery of any sort in this era was done without the aid of modern blood transfusion and antibiotics. All surgery of any sort in this era was riskier than similar surgery today. This is the era where kitchen-table surgery was phasing out in favor of hospital-based surgery. I have an obstetrical nursing textbook from this era that describes how to set up an operating table in the woman's home to perform a c-section.

Blood banks were cutting-edge battlefield medicine just a few years before, and had not yet come into common usage. Blood type compatibility was not yet understood. It wasn't until the late 1930s and early 1940s that things like separating blood products started to come into practice. Antibiotics were not manufactured and used widely until after WWII. (See chart, below)

So keep in mind that things that may seem appalling to us in the early 21st century -- such as performing surgery in one's home -- was not appalling at the time. Things we take for granted, like antibiotics and blood banks, were still in the future.

This is all pregnancy-related deaths, including legal abortions, criminal abortions, miscarriages, ectopic pregnancies, and all complications of pregnancy, labor, and childbirth.

There was a very precipitous drop in all maternal mortality rates from 1920 to 1950. The steepest drop started in the late 1930s. Since this drop was due to overall improvements in health and sanitation, they were probably more pronounced in childbirth. If anybody's interested I can explain that a bit more. But still, abortion mortality probably was falling during this period as well, since a healthier woman is more likely to survive an abortion than an unhealthy woman, and doctors who are washing their hands and cleaning their instruments prior to assisting in a delivery or a therapeutic D&C are also likely to do so when doing abortions.

With that established, let's look at some examples of women who died in 1921, and who did their abortions. I did not choose these cases because I thought they made a particular political point, but because they were the cases I was able to find information about.

Jennie Chubb died in her Chicago home of an abortion performed there that day. I've been unable to determine the profession of the perpetrator.

Virginia Rappe (pronounced "rah-PAY", pictured) died under mysterious circumstances, after taking ill at a party thrown by Roscoe "Fatty" Arbuckle. Though Arbuckle was originally blamed for Virginia's death, an investigation indicates that Virginia likely had suffered her injuries during what would have been her fifth abortion at Wakefield Sanitorium, a maternity hospital run by Dr. Francis Wakefield and Josephine Roth, and known for performing quasi-legal abortions. I count Virginia as an abortion performed by a doctor because that was by far the most likely scenario.

Iva Triplett died after an abortion performed by Dr. C.W. Milliken. Iva's widower, on behalf of himself and the couple's children, sued Milliken for the injury and for failure to inform Iva's family of the nature of her illness so that they could seek and provide appropriate care for her.

Here is a breakdown of who performed the fatal abortions I've uncovered for the 1920s:

If we figure that the least likely to die are those who get a doctor to do their abortions, and the most likely to die those who take things into their own hands, this small sample is in keeping with the estimates of Mary Calderone and Nancy Howell Lee, that about 90% of criminal abortions were done by doctors.

Better childhood nutrition, better sanitation, and the introduction of sulfa drugs (and later penicillin) were probably the main driving factors. And consider that during the Roaring 20s -- the Jazz Age -- sexual promiscuity was at a record high. Yet abortion deaths fell while abortion remained a criminal act, unsanctioned by church or state.

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